The Importance of Vitamin B1 after Gastric Bypass & Sleeve

Vitamin B1, or thiamine, is an essential component of the B-complex vitamin family that aids in converting food into energy. Thiamine is essential for various bodily functions, including metabolism, nerve function, and brain health. Like all B vitamins, it’s water-soluble and must be replenished daily through diet or supplements.

However, those who have undergone gastric bypass or sleeve surgery should pay special attention to vitamin B1. These surgeries may interfere with the absorption of nutrients, including thiamine. Therefore, bariatric patients must be more vigilant about their vitamin B1 levels.

In this article, we will explore why post-bariatric patients should pay special attention to their vitamin B1 levels, its importance, signs of deficiency, and its impact on various aspects of health. We will also highlight recent research findings, comprehensively understanding this crucial nutrient’s role in post-bariatric surgery life.

What is vitamin B1?

This vitamin was the first identified in vitamin B complexes (therefore using the term vitamin B1). It plays a central role in the production of mitochondrial ATP.

It is an essential and rate-limiting cofactor in many processes, particularly at the entry points and critical junctions of the glucose, fatty acid, and amino acid pathways.

The importance of vitamin B1 for the body

Our body requires vitamin B1 to carry out many important functions. It is necessary for:

Maintaining a healthy blood level
Fueling the body by converting food into energy
Maintaining proper nervous system function
Generating DNA and RNA

Vitamin B1 and Gastric Bypass/Sleeve Surgery

Gastric bypass or sleeve surgery patients experience significant changes in their digestive anatomy, affecting their ability to absorb nutrients. Although most individuals receive vitamin B1 as part of their post-surgery multivitamins, vitamin B1 deficiency is a common concern for post-bariatric patients. Hence, the question arises: do they get enough?

Are You Getting Enough Vitamin B1 after Bariatric Surgery?

The first step in addressing the importance of vitamin B1 after bariatric surgery is understanding whether you are getting enough. Several studies have shown that post-surgery patients are at risk for thiamine deficiency despite initial supplementation. Some individuals may need additional support, such as benfotiamine, a fat-soluble form of vitamin B1 that offers better absorption.

In order to maintain an optimal level of vitamin B1, patients, and their physicians must recognize the importance of keeping vitamin B1 levels optimal. However, some patients may not follow up after the first year or stop monitoring their vitamin levels, resulting in potential deficiencies. This is why paying attention to the symptoms associated with B1 deficiency is essential.

Vitamin B1 deficiency: Symptoms

A vitamin B1 deficiency occurs when the body does not have enough vitamin B1. Some common symptoms and signs include:

Fatigue and Weakness

Vitamin B1 deficiency can lead to fatigue and generalized weakness. Bariatric patients who experience persistent tiredness may need to investigate their thiamine levels.

Nerve Damage

Nerve function depends on thiamine. Its deficiency can cause numbness, tingling, and nerve pain, particularly in the hands and feet. For post-surgery patients with altered nutrient absorption, nerve health is particularly crucial.

Memory and Cognitive Issues

Vitamin B1 deficiency can cause memory problems, poor concentration, and brain fog. Mental health issues can be especially challenging for bariatric patients.

Gastrointestinal Distress

In post-bariatric individuals, GI issues such as constipation and diarrhea can indicate thiamine deficiency. These problems can impact the quality of life and nutrient absorption further.

Cardiovascular Problems

Thiamine is integral to cardiovascular health. Its deficiency may increase heart rate, cause shortness of breath, and lead to heart complications. This is particularly important for bariatric patients who may have a history of cardiovascular problems.

Muscle Wasting

Insufficient thiamine levels may also cause muscle wasting in bariatric patients, affecting their overall strength and health.

Psychological Symptoms

Vitamin B1 deficiency can also cause psychological symptoms, including anxiety and depression, which can be particularly challenging for individuals undergoing significant weight loss or life-altering surgeries.

As well as these symptoms, thiamine deficiency may lead to many serious health problems.

Beyond the Basics: Thiamine and Its Impact on Health

Vitamin B1 deficiency affects more than just the body’s basic functions. There are a number of aspects of health and well-being that it may affect.

Blood Sugar Regulation

Thiamine plays an essential role in maintaining stable blood sugar levels and carbohydrate metabolism. Post-bariatric patients, especially those with diabetes or prediabetes, must pay special attention to their vitamin B1 intake. Health complications and issues can arise from fluctuating blood sugar levels.

Alzheimer’s Disease

There is emerging evidence that thiamine might protect against neurodegenerative diseases like Alzheimer’s. It is even more important to ensure adequate thiamine intake in post-bariatric patients due to their increased risk of cognitive decline.

Beriberi

Thiamine is used most commonly for treating beriberi, which is caused by insufficient thiamine in the diet. Symptoms include:

Hands and feet swell, tingle, or have a burning sensation
Confusion
Breathing problems due to lungs filled with fluid
Nystagmus (uncontrolled eye movements)

Wernicke-Korsakoff syndrome

Thiamine deficiency also causes Wernicke-Korsakoff syndrome. In reality, Wernicke-Korsakoff is two disorders.

Wernicke disease, nerves in the central and peripheral nervous systems are damaged. In many cases, it is caused by malnutrition resulting from alcoholism. But unfortunately, can be seen in bariatric malnutrition.

Memory problems and nerve damage characterize Korsakoff syndrome. The use of high doses of thiamine can improve muscle coordination but rarely improve memory loss.

Cataracts

Several nutrients may reduce the development of cataracts, including thiamine. A diet rich in vitamins A, B1, B2, and B3 (or niacin) and protein reduces the risk of cataracts. Additionally, getting enough vitamins C, E, and B complex vitamins, especially B1, B2, and B9 (folic acid), may prevent cataracts from developing. However, a greater amount of research is needed.

AACE, TOS, ASMBS Guidelines

The American Association of Clinical Endocrinologists (AACE), the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society (TOS) have published guidelines that address vitamin B1. These guidelines offer valuable insights into monitoring and managing vitamin B1 levels post-bariatric surgery.

Here’s a concise summary of AACE, TOS, and ASMBS Guidelines:

Who Should Be Checked for Vitamin B1 Deficiency?

People with risk factors for thiamine deficiency, which include:

– Females

– Black individuals

– People who don’t go for check-ups at a nutrition clinic after surgery

– Those with stomach or intestine problems like severe nausea, vomiting, or constipation

– People with heart issues who take medications like furosemide

– Those with a condition called small intestinal bacterial overgrowth (SIBO)

– Others at risk due to malnutrition, too much weight loss too fast, or too much alcohol use.

If people who’ve had weight loss surgery show signs of a deficiency or have these risk factors, doctors should check their vitamin levels at least in the first 6 months after surgery and then every 3 to 6 months until the symptoms get better. This helps ensure they stay healthy and get the right treatment if needed.

Thiamine Supplementation:

To prevent its deficiency, take around 12 milligrams of thiamine daily. But preferably 50-100 mg daily. It’s best to get this from a B-complex supplement or a strong multivitamin. However, if you are diagnosed deficient in thiamine, the treatment depends on how severe your deficiency is:

– If it’s not too bad, you can take 100 milligrams of thiamine by mouth 2 to 3 times a day until you feel better.

– If it’s more severe, you might need thiamine through a vein (IV). You could get 200 to 500 milligrams 3 times a day for 3 to 5 days, then 250 milligrams a day for another 3 to 5 days, or until you feel better. After that, you can take 100 milligrams by mouth daily, maybe forever, or until the risk factors are gone.

– Sometimes, you might get thiamine with a shot (IM). You’d get 250 milligrams once a day for 3 to 5 days or 100 to 250 milligrams once a month.

Refeeding Syndrome Risk:

If you’re at risk for refeeding syndrome, your doctor might also give you magnesium, potassium, and phosphorus at the same time to keep you healthy. Refeeding syndrome can happen when you start eating after not eating much for a while. It can be dangerous, so getting the right nutrients is important.

Continuous Monitoring and SIBO Consideration:

If you keep having problems with your thiamine levels even after treatment, your doctor may prescribe antibiotics to treat a condition called small intestinal bacterial overgrowth (SIBO), which can also affect thiamine levels.

Exploring Benfotiamine

Several studies have explored the use of benfotiamine, a fat-soluble form of vitamin B1. Post-bariatric patients struggling with thiamine deficiency may benefit from this form of thiamine because it may promote better absorption. Although conventional medicine might not recognize this form, it is still worthwhile to discuss since it can benefit some patients. Include a balanced viewpoint on benfotiamine, highlighting its potential benefits and any factors to consider for those contemplating supplementation.

Benfotiamine Scientific Foundation

Let’s examine the scientific basis for benfotiamine’s health-promoting and disease-preventing properties:

Enhanced Bioavailability: Benfotiamine is fat-soluble, which makes it more effective for absorption and tissue penetration than traditional thiamine supplements. A recent pharmacokinetic study shows a five-fold improvement in bioavailability.
Anti-Inflammatory Properties: The anti-inflammatory properties of benfotiamine have been demonstrated via its ability to inhibit active signaling pathways that participate in inflammatory processes. It can thus be used to treat chronic illnesses associated with underlying inflammation.
Neuroprotection: Benfotiamine promotes nerve regeneration and health, making it an excellent therapy for conditions related to neuropathic pain.

Benfotiamine Supplementation in Clinical Practice

Neuropathy Management: Benfotiamine has neuroprotective properties that can be particularly beneficial in treating neuropathy. A study showed it relieved symptoms associated with diabetic neuropathy, alcoholic and chemo-induced neuropathy, sciatica, and nerve impingement.
Diabetes Care/Improved Blood Sugar Control: Diabetics often experience problems related to glucose metabolism and nerve function. This medication has the ability to improve glucose control as well as reduce the risk of diabetic complications such as retinopathy and nephropathy.
Cardiovascular Health: Benfotiamine contributes to improved cardiovascular health through its ability to reduce inflammation and protect vessels. There is potential for its use in treatments for conditions such as atherosclerosis and hypertension. Compared to drugs and surgery, it certainly offers superior results.
Mental Health: Nerve health is directly related to mental health. Benfotiamine supports nerve function, which may benefit depression and anxiety conditions.
Alzheimer’s Disease: Despite continued research into the neuroprotective properties of benfotiamine, it seems that the compound may have some potential applications for managing or preventing neurodegenerative diseases, such as Alzheimer’s.

Vitamin B1 food sources

In addition to supplementation, the following foods are rich in vitamin B1 and can be included in the post-bariatric diet:

Asparagus: ½ cup provides 0.1mg of vitamin B1
Brown rice, long grain (cooked): ½ cup provides 0.1mg of vitamin B1
Cantaloupe: ½ cup provides 0.11mg of vitamin B1
Fish, Salmon, wild-caught (3oz): Provides 0.30mg of vitamin B1
Flax seeds: 1oz provides 0.50mg of vitamin B1
Green peas: ½ cup provides 0.21mg of vitamin B1
Lentils: ½ cup provides 0.17mg of vitamin B1
Milk: 1 cup provides 0.10mg of vitamin B1
Orange: 1 fruit provides 0.11mg of vitamin B1
Pecans: 1oz provides 0.19mg of vitamin B1

Conclusion

Vitamin B1 is a crucial element of post-bariatric nutrition and health. Patients who understand its significance and impact on various health aspects can take proactive steps to ensure they get enough of this essential nutrient.

Recent research suggests that benfotiamine, a special type of vitamin, could be helpful. Thiamine deficiency can affect blood sugar, mental health, and heart health and might be linked to Alzheimer’s disease.

Eating the right foods can help keep thiamine levels up, which is good for your health. So, understanding the importance of vitamin B1 after surgery and ensuring you get enough is key for long-term health. More research and awareness will help post-surgery people start their new lives feeling healthy, confident, and strong.